title: Hepatitis E: the forgotten virus.
abstract: Hepatitis E virus (HEV) has a long military association being first discovered during the Soviet occupation of Afghanistan in the 1980s after an outbreak of unexplained hepatitis at a military camp. HEV is now endemic in the UK, and should be considered in all cases of jaundice. The prevalence is high in certain operational areas (28.5% in Afghanistan), and maintenance of integrity of food and water supplies together with scrupulous attention to environmental hygiene remains paramount. Pregnancy confers a much higher risk of fulminant hepatitis, with a mortality rate of up to 25%. Management is usually symptomatic, but ribavirin can be considered in non-pregnant patients with fulminant hepatitis. This narrative review examines the presentations and management of Hepatitis E in military populations.
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Freshwater
mesh_terms: D016751:Hepatitis E / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D016752:Hepatitis E virus; D006801:Humans; D015994:Incidence; D007565:Jaundice / Q000821:virology; D008889:Military Personnel; D015995:Prevalence